water saffron, pockmarks and injuries.
sounds easy to pronounce, but it actually refers to the time when rash appears after the onset of 6 infectious diseases.
water, chickenpox , usually a rash will appear as soon as you have a fever.
red, scarlet fever , usually a rash will appear the next day after fever.
flowers, smallpox , have now been eliminated.
measles, measles . A rash appeared all over the body around the fourth day.
spots, typhus , rash appeared on the fifth day of onset.
injury, typhoid fever , the rash usually appears on the 6th day of illness. Not to mention
, it is really useful.
In the early spring of one year, we admitted a soldier to our ward. He had a high fever, low white blood cells, and no inflammation in his lungs.
first diagnosis fever pending investigation . This is a major disease that requires differential diagnosis in internal medicine: infectious diseases, autoimmune diseases , malignant tumors such as blood diseases.
Infectious diseases are further divided into: bacterial and non-bacterial. Bacteria are divided into common pathogenic bacteria and rare pathogenic bacteria. Non-bacterial subdivision: viruses, rickettsiae, parasites, spirochetes , etc. Infectious diseases are the most common.
So, do the examination, draw blood tests, analyze the test results, and make differential diagnosis. After patient
was admitted, he had no more symptoms and still had a high fever. Later, his liver and spleen also began to enlarge.
High fever, hepatosplenomegaly, the doctor even thought of blood diseases, and also did bone marrow puncture.
On the fifth day of the patient’s illness, the doctor found a rash on the patient during a ward round.
This was supposed to be a good reminder. The young doctor in charge of the bed found the attending doctor and wanted to discuss what the rash was.
However, doctors attending to ignored .
When she saw the rash, she thought of drug rash. Because the patient also used antipyretic and analgesic drug at that time.
So, I was told to give some " dexamethasone " according to the drug rash, which is a hormone. The rash subsided the next day. The doctor thought it was drug rash and treated it correctly. In fact, rashes caused by infectious diseases will sometimes subside in a day or two.
At this time, the test results came out. The Waifei's reaction was strongly positive, so positive that even after diluting a row of test tubes, was still positive.
The diagnosis is clear, Typhus . Feifei's reaction is a relatively specific laboratory indicator for the diagnosis of typhus.
Typhus, Rickettsia infection . Rickettsia are larger than viruses and smaller than bacteria. This kind of rickettsia lives on lice or fleas. When sanitary conditions are poor, lice can be transmitted to someone with typhus. Half a month before the onset of the disease, the patient had a history of traveling by train in the north on a business trip. It is speculated that he was infected by contact with someone who had lice on his body at that time.
Typhus treatment uses tetracycline, oxytetracycline family of drugs, and the doctor gave the patient " doxycycline ". now uses " doxycycline ".
The medicine can cure the disease.
After taking doxycycline, the patient's body temperature dropped immediately. He no longer had a fever a day later and was discharged after continued treatment.
Many infectious diseases that cause rashes include fever in the early stage, and the symptoms are not special, sometimes just like an everyday cold. The timing of the rash can help us identify it. Some patients come to the clinic after the time of developing rash. Asking about the medical history and reviewing it can also be helpful. After that, we diagnosed typhus patients who had already developed rashes and found out by following the medical history.
Okay, remember it again, water, red, flower, hemp, spot, injury.
Hou Xiaoping, Department of Cardiovascular Medicine
